1. Field of the Invention
This invention relates to a protective device to help to avoid wound punctures while using sharp dental or medical instruments.
2. Description of the Related Art
In the practice of dentistry, it is necessary in most procedures to manipulate various kinds of instruments in the patient's mouth. One notable example is the cleaning of the teeth which should be periodically performed to remove plaque, tartar and calculus from the teeth. If left undisturbed, this material can lead to the formation of gingivitis and periodontitis.
As is commonly known, the cleaning procedure involves the scaling or scraping away of such matter that has adhered to the surface of the teeth, especially in the vicinity of the gum line and in intra-proximal regions. For this purpose, a dental hygienic technician or a dentist utilizes scalers, scrapers, or picks shaped at their operative ends in various configurations designed to achieve the necessary scraping and cleaning action.
As the cleaning proceeds, these scalers or picks inevitably collect at their operative ends the plaque or other debris removed from the teeth. Consequently, the end of the instrument must be freed of this debris at frequent intervals so that further cleaning can proceed without interference by the accumulated debris on the cleaning action of the instrument or obstruction of the field of view of the practitioner of the site being cleaned.
Typical dental chairs are equipped with instrument trays mounted on articulated and pivotable arms permitting the tray to be positioned at a location relative to the operator and patient affording convenient access to various instruments and the like placed thereon for use in cleaning. For ridding the end of the cleaning instrument of the accumulated debris, there is ordinarily placed loosely on this tray a paper tissue, gauze pad, or other absorbent wiping material with which the practitioner can wipe the instrument end free of adherent matter. In the step of cleaning the instrument, the instrument comes in close proximity to the practitioner's hand, which is protected only by a plastic glove. This introduces a significant risk of the occurrence of the penetration of the skin of the hand holding the wiping material by the sharp instrument.
Since the advent of the wide-spread dissemination of HIV and hepatitis viruses, much attention in the health care professions has been given to the avoidance of the penetration of the skin by sharp points of hypodermic needles and the like used in the administration of medicaments to patients either at the time of administration or subsequently in the disposal of the needles.
It is now common knowledge that such needle or instrument sticks can result in the transmission to the practitioner of serious diseases carried by the patients, including AIDS and hepatitis, the viruses of which are known to be present in oral mucous as well as in blood serum and other bodily fluids. Thus, microorganisms from dental patients can be borne by debris, mucous, and blood collected on the ends of cleaning instruments and transmitted to a practitioner by an accidental pricking or scratching of the skin with potentially serious consequences. Any measure for reducing the possibility of casual instrument sticks in the dental field is highly desirable.
The same considerations with attendant risks obviously apply to other dental procedures including endodontic and periodontal procedures, filling of teeth and the like employing files, reamers, probes, drills, and other instruments which become coated with mucous or blood during the procedure and likewise require wiping or cleaning from time to time.
In view of these risks, in 1993 the Centers for Disease Control published guidelines for controlling infections in hospitals. One section, entitled “Blood and Body Fluid Precautions”, recommended that certain precautions be taken in handling the blood and body fluids of patients who were known or suspected of being infected with blood-borne pathogens. Special precautions were recommended to be followed with such patients. The Federal Register of Dec. 6, 1991, in “Blood-Borne Pathogen Standards” under Methods of Compliance, stated in pertinent parts that universal precautions shall be observed to prevent contact with blood and other potentially infectious materials under circumstances in which differentiation between body fluid types is difficult or impossible, all body fluid shall be considered potentially infectious material. Under Engineering and Work Practice Control, it notes that engineering and work practice controls shall be used to eliminate or minimize employee exposure or when occupational exposure remains after institution of these controls, personal protection equipment shall also be used, such as gloves, masks, etc.
The prior art contains teachings of devices which are designed to minimize the risk of accidental contamination with oral debris by providing methods of cleaning sharp dental instruments by means other than gauze held by a gloved hand.
U.S. Pat. No. 4,439,884 discloses a round, cup-like container having an array of bristles around the inside surface of the container pointing toward the center of the container. A dental instrument is inserted through the top of the container and the bristles brush against it to clean it. The device is maintained in an upright position, the bottom may contain liquid, and the device may be taken apart to be cleaned.
U.S. Pat. Nos. 5,308,406 and 5,471,706 disclose devices for cleaning dental instruments. The first of these references discloses a cylindrical container with bristles covering the inner surface and extending toward the center. The device stands on its own, may be taken apart for cleaning, and is deep enough to hold a pool of liquid in the bottom. The device has a self-sealing entrance made of flexible material to contain the liquid. Additionally, there is a protective collar around the opening. The second of the above patents discloses the same container and additionally discloses a means for withdrawing liquid from the container by attaching the device to a source of suction.
U.S. Pat. No. 5,477,581 discloses a device for cleaning dental instruments which contains a strip having adhesive material on both the top and the bottom. The bottom of the strip attaches to a dental tray and the top attaches to two adjacent rolls of rough absorbent material. The tip of the dental instrument is placed between the two rolls for cleaning.
U.S. Pat. No. 5,704,088 discloses a device for cleaning dental instruments. The device may be held in one hand while the instrument is held in the other. The device is made up of a flexible sealed chamber having a hinge, a bottom and a top. The bottom and the top have brush elements. The portion of the instrument to be cleaned is placed between the brush elements and the flexible top and bottom are compressed to apply pressure to the brush elements.
U.S. Pat. No. 5,778,480 discloses a device for cleaning dental instruments. The device contains a saucer which is attached through a clamp to the dental tray. A cleaning head is carried on top of the saucer, and the dental instrument is cleaned by rubbing the instrument against the cleaning head.
U.S. Pat. No. 6,257,888 discloses a device for cleaning dental instruments. The device is made up of a small container which adhesively attaches to the back of a plastic glove. The container carries two pieces of a flexible wiping medium such as cellular foam or quilted dental padding. The tip of the instrument is placed between the two pieces for cleaning.
U.S. Pat. No. 6,280,529 shows a laminated pad of gauze or sponge for cleaning dental instruments. The pad may be attached to the back of a glove by adhesive or a strap and the instrument may be cleaned by wiping it over the pad.
The above devices, while being useful, contain inherent disadvantages. The stand-alone devices which contain bristles are complex devices which may be seen to be not worth the cost in order to replace a nearly cost-free procedure. Also, in the absence of pressure being applied to the bristles, the instruments may not be cleaned to the extent desired. The devices which attach to gloves become inconvenient when they must be transferred every time gloves are changed. In each of the discussed devices, the practitioner has the choice of changing the device or at least the cleaning surface of the device or subjecting a dental instrument being used in one patient to the debris removed from previous patients. The first option becomes expensive while the second option is so unsanitary as to not be a viable option.
In spite of the multiplicity of devices for cleaning dental instruments which has been made available to the dental profession, the method of choice remains picking up a piece of gauze and wiping the tip of the instrument with the gauze while applying pressure. While being simple and inexpensive, this method carries with it the possibility of punctures and cuts which can introduce unwanted pathogens into the bloodstream of the practitioner.